Strong heart palpitations: what to know

Palpitations may feel like pounding, racing, fluttering, skipped beats, or a thump in the chest. They can occur with anxiety, caffeine, fever, dehydration, low blood sugar, thyroid overactivity, or anaemia. Some people have a rhythm problem such as atrial fibrillation; the sensation alone cannot distinguish it from a harmless temporary change.

Record the time it starts, how long it lasts, whether the rhythm feels regular or irregular, what you were doing, and symptoms such as dizziness, breathlessness, chest discomfort, or faintness. A clinician may check your pulse, medicines, and general health and decide whether heart monitoring is useful.

Stop strenuous activity, sit or lie safely, and breathe slowly. Avoid caffeine, nicotine, recreational drugs, and decongestants until you have discussed the episodes with a clinician. Drink fluids if dehydration may be contributing and follow an agreed plan if you have diabetes or a history of low blood sugar.

Arrange a medical review when palpitations are new, recurrent, becoming stronger, lasting longer, or occurring with reduced exercise tolerance. Bring a list of medicines, supplements, and recent illness details.

Call emergency services for palpitations with chest pressure or pain, severe breathlessness, fainting, collapse, confusion, or new weakness. Seek urgent assessment if a fast or irregular heartbeat does not settle, especially if you feel dizzy or unwell. Do not drive yourself if you might faint.

Ask whether you need an ECG, blood tests, or rhythm monitoring; whether any medicine could be contributing; and what pulse or symptoms should prompt emergency care. Mention thyroid disease, anaemia, diabetes, heart conditions, pregnancy, and family history when relevant.